Alternative names

Papanicolaou test

Definition

A Pap smear is a microscopic examination of cells scraped from the cervix.

How the test is performed

The Pap smear is performed as part of a gynecological exam. You will lie on a table and place your feet in stirrups to position your pelvis for examination. A speculum (an instrument used to open the walls of the vaginal canal to see the interior) will be inserted into your vagina and opened slightly.

A sample of cells from the outside and the canal of the cervix is taken by gently scraping the outside of the cervix with a wooden or plastic spatula, then inserting a small brush that looks like a pipe cleaner into the canal.

The cells are placed on a glass slide and sprayed with a fixative, or put in a bottle containing a preservative, then sent to the lab for examination.

How to prepare for the test

The health care provider should be notified if you have had a prior abnormal Pap smear, if you might be pregnant, or if you are taking any medications or birth control pills. You should avoid douching, using tampons, having intercourse, and tub baths 24 hours before the test.

Avoid scheduling your Pap smear while you are menstruating, because blood and cells from the endometrial cavity may obscure the accuracy of the Pap smear. Empty your bladder just before the test.

How the test will feel

There may be some discomfort and a feeling of pressure during the procedure. A small amount of bleeding may occur after the test.

Why the test is performed

The Pap smear can detect cancerous or precancerous conditions of the cervix. For recommendations on the frequency of having this test done, see the information on cervicitis.

Normal Values

A normal value is negative, meaning there are no abnormal cells present.

What abnormal results mean

Abnormal values are based on the test results. The current system of reporting divides the results into three main areas: benign (noncancerous), precancerous (showing some abnormal cell changes), and malignant (possibly cancerous).

A report in the latter two categories will usually lead to a follow-up examination, including a repeat Pap smear and possibly other tests. If you have never had an abnormal Pap smear before, and the result indicates a mild abnormality, the Pap test is repeated in 6 months.

If the test result suggests a severe abnormality or cancer, you may need an immediate colposcopic evaluation with biopsies. If you have had an abnormal Pap test in the past, or have had treatment for a precancerous change, you may need an immediate colposcopy.

The Pap smear is a screening test. Any abnormal results should be discussed with your health care professional, who will help determine if a colposcopy is necessary.

What the risks are

There are no risks involved.

Special considerations

The following drugs may affect Pap smears:

Colchicine
Estrogen
Podophyllin
Progestins
Silver nitrate
Compounds in cigarettes

source: http://www.nlm.nih.gov/medlineplus/ency/article/003911.htm

more info (click on the thumbnails to view a bigger picture):

Pap smear

A Pap test is a simple, relatively inexpensive procedure that can easily detect cancerous or precancerous conditions. During a Pap smear, cells from the outside and the canal of the cervix are retrieved by gently scraping the outside of the cervix. The Pap smear is performed to detect cancerous or precancerous conditions of the cervix.

nice post, & btw, how much does the test cost

yeah.. how much it cost here in Malaysia? I noticed shadowprincess is in canada... -.-"

thanks alot for the information...! it's really helpful..

btw.. what is "colposcopy " don't quite understand even after reading the pamplets attached...

many thanks again!!

colposcopy = Examination of the vaginal and cervical epithelia by means of a colposcope.

colposcope = A magnifying and photographic device used as an aid in the diagnostic examination of the vaginal and cervical epithelia.

It costs around RM100 including lab tests for the cells. I went to TTDI's Apollo clinic to get mine done - female gyne AND very friendly. Results come out in two weeks. Pretty fast.

it costs RM1 if you go government maternity and child health clinics.

sorry wrong post. delete this.

This post has been edited by skippro: Mar 19 2006, 04:21 AM

Whats the doctors name? and which part of TTDI is Apollo clinic?

which part of TTDI?? mind to elaborate more?

meiteo,
how do they send the results? by post or self collect? thanks

people, if we wana do pap smear n std test , will they phone our house and tell our parents if they is sumthing wrong?or will they post the reaults to our house?

what is the best age to do pap smear? sum say better do it after u're married...is it true?

Yup..after married...coz this test is tyo test cervical cancer by HPV....and the risk of cervical cancer is proportional to the number of SI(sexual intercourse) had....that's y it's only necessary after u get married....Unless u're having SI before married...

IT Only costs rm 30 .

i did the pap smear test in lourdes clinic jalan ipoh, cost me rm100 n can get the result 10days after the test...women who is sexually active shoud do the pap smear test..

i think pap smear should be encourage among sexually active women, because it's a very useful test to diagnose early abnormal changes.

according to clinical doctors, cervical cancer is very easy to treat if detected earlier. However, the problems of cervical cancecr is that the cancer only present signs and symptoms at a very late stage.

another word is that, when patients approach doctors about the problems they face: leuchorrhoea, dysparunia, vaginal bleeding, dysuria... it's already in late stage and the prognosis is not that good.

In US, cervical cancer was the leading cause of death 50 years ago, but with the screening with pap smear, cervical cancer has reduced this to the 8th cause of cancer mortality in women in US today.

the peak age of Invasive Carcinoma( agressive type)--> 5th decade
in situ carcinoma ( non agressive)----> 3rd decade

Pap smear is indicated in sexually active women only and advised at least once a year.



This is wrong, Carcinoma means aggresive. IN-situ carcinoma means that the malignant/dangerous cells have yet to break through the basal membrane. Hence the chances of spread to other body areas are minimal.




For government clinics they will call you regarding your results. Not too sure about private clinics though.




Risk factors for cervical cancer include
1) early sexual intercourse
2)Multiple sexual partners
3)Sexually transmitted diseases
4)Human Papilloma virus infection


This post has been edited by Bodhi: Sep 1 2006, 09:58 AM

Just go to LPPKN it is cheaper there than others hmm for women who sexually active

any recommended clinic or doctor for this? i might one to test this out too.

Ok i got a few questions. Some people insist that pap smears are only for married women. However i feel that it is really important to get it done annually at least. My mum managed to detect pre cancerous growth from her pap smear and fortunately it was still at a stage where an operation was all that was needed as it had not turned to cancer yet.

you should do it annually (yes i'm a guy but i've had enough gfs to learn more than i wanna know about women's health). ESPECIALLY if you're sexually active. in fact i think thats where "only after you're married" bullshyte comes from, because you know, you're only supposed to have sex after married (that's sarcasm btw)

pap smears ar suppost to do it after u have sexual intercourse. u should do it annually.
nowadays is not bout doing it after married, is doing it after u r sexually active.

got 1 ques, bout the bleeding part, would it bleed like period o jus a bit for jus a day?does it hurt a lot? thanks

This post has been edited by Anonymousmich: Dec 4 2006, 12:56 PM

Just wanna ask, since the it says that an instrument would be inserted into the vagina.

So... um... would it damage the hymen? Or it won't go that deep? What if the doctor accidently slips and tears the hymen??

>_<

normally pap smears for those tat is not virgin...

Oooh, sorry sorry. Blur already.

Can pap smear detect endometriosis?

i dont think so. pap smear is use to detect cervical cancer.

But Malaysian said in the post above that pap smears are not for virgins but since you said it's used to detect cervical cancer, does that mean a virgin could and should also go for pap smears?

I think virgin have less probability of getting such cancer.

Absolutely untrue, one's virginity has nothing to do with it.

So that means even virgins should go for checkup? I've asked about the chances of rupturing the hymen during checkup in my earlier post so... would/could the procedure rupture the hymen?

Pap smear done for married women or women who are sexually active only.
For virgins, pap smear is not required and so no question about rupturing the hymen.

As to why it was concluded that pap smear is unnecessary for virgins was because it was found that nuns have zero incidence of cervical cancer

No. Based on clinical suspicion first and then on ultrasound of uterus.

if virgin has abnormal period or symptom..they have different kind of test for it.

Depends on what kind of period and what symptoms. For virgins the diagnosis is usually derived from the history and an abdominal examination, a per-vaginal examination is NOT done and is replaced with a digital rectal examination if required. Most of the time an ultrasound of the lower abdomen is performed which is sufficient to rule out most diseases.

bodhi, it doesnt mean that if u r a virgin, u will escape from having cervix ca. sexually active will pre dispose u getting it or increase the risk of having it..

How was the surgery Clareen?
Yes, it is recommended that females do a PAP every 2 years. A very simple procedure but saves a lot of lives.

We normally do not perform PAP on non-sexually active girls unless they insist.
The speculum is inserted all the way, so yea, it is deep

For those who are concern about this (especially those who have a family history of cancers) and age between 14-26, pls google 'HPV vaccine or Gardasil', a breakthrough in preventing cervical cancer, 1st vaccine available for cancer (other than Hep B vaccine which indirectly prevents)
This is not an advertisement, our duty includes providing sufficient information for patients to make an informed decision. Feel free to contact any hosp/clinic regarding this to know more.
And to medical students/medical staff, I suggest do sufficient research first before telling patients about the concept and effectiveness of vaccines. I am tired of ammending patient's misconception regarding vaccination due to incorrect/subjective information conveyed by undergrad med students.

This post has been edited by veon: Jan 27 2007, 04:01 PM

Another question here. Is there a specific period for us to have pap smear? I mean like 1 week before period or 1 week after period? Anything we should avoid before doing pap smear?

painful or not?

is recommended to hv it 2 weeks after d 1st day of ur last period...

u shld avoid sexual intercourse d day b4 u had d test...n any other medication that u apply near ur vagina...

when i used to had training in d hospital....d result is actually ready by 2 days...

yaya.. painful or not geh? I remember they need to use a tool to open up our vagina right? It's a bit of nightmare to me. Will i bleed?

it very much depends on d skill of ur healthcare worker...

most of d time it is not painful....but some time, there will be bleeding, if d staff is too harsh on u or they use d wrong technique or mayb new staff still doesn't got d skill right...

is d same situation as blood taking.....some ppl would said that they had some different experience...some time is painful, sometime it is not...becoz if diff ppl redrawing their blood.

wah.. you are so knowledgeable about this stuff ya... looks like i cannot go to government hospital if want to have this test next time:P.

yea, coz i had training in a hospital lab for 2 months...

i had to said that u can't underestimate government hospital when it comes to manual skills....coz d more practise d health worker got, the more skillful they will become.....n when u know d amount of patient they got per day compare to private hospital, u will get wat i meant...

for virgins that is concer about cervical cancer you can opt go get ca125 blood test, it is used to detect cervical cancer as well. However it is not as accurate as pap smear, and the result may vary due to ur health conditions ie imflamations such as soar throat, it may tend to increase the ca 125 count. If u r planing to go on ca125 blood test please make sure that u r not on medication or having period or near to having period or just finish ur period. The ideal date for the ca12 blood test is around 1 to 2 weeks after period.

Hope this is informative enuf for those virgin that is concern about cervical cancer

Actually virgins do not need to go for pap smear test. This is because Cevical carcinoma is caused by HPV (Human papiloma virus) which is transmitted via sexual intercourse. This virus will trigger the cell proliferation in the cervix area and thus proceed to carcinoma (cancer). Other causes of cervical cancer is also through sexual intercourse.

So all the virgins out there, don't worry. As long as you are not engaged in sexual intercourse, there's no reason for you to undergo pap smear test.
This is a credential statement.

not really blumaroz..
cancer wont chose a sexually active person only..
there are many cause of cervical cancer.. and it might not be the HPV that cause it but ur genetic etc..
so, a virgin also advised to take this test.. as you wont know the cancer existance until its too late as there are no sensory nerve down there..

Hi Ladies

Sigh........................................................

isk isk isk... spoil2...

Yeah, i agree with shue too. For your information everyone have cancer cells inside their body. Depend when it will turn to bad condition.

Beside, that genetic might be one of the root cause. Family that has cancer history, they should really monitor their health seriously.

this two statement very the contradicting

Blumarooz: you say yours is a credential statement.. care to explain more? are you in medical field? or you get that statement from somewhere/someone?

phew, sounds scary. luckily im a guy! hehe

if u going..just look for gynae not normal clinic as gynae normally have more experience...gov hospital..better dun try....the problem with them is not related to their experience but working altitude.

Really? Prostate problems? Erectile Dysfunction? Urinary retention? varicosed testicles?


A normal gynae clinic is good enough I think. Every gynae should train in these related areas before they can open a clinic.

Pap smear examination is not allowed to do on a virgin. cuz the procedure will tear the hymen.

Cervical cancer normally seen in sexually active women, but there are cases reported rare but it happens in virgins. studies shown there is a very close relationship between the cervical cancer and the HPV.

There is a HPV vaccine in the market. kinda pricey.. but it only cover 4 types of HPV and it is effective for those taken before the age of 26

wait till you hear about how they check for prostate cancer... finger up the anus!
don't believe me? ask a doctor

eeiii...... sound likes gay.. kekekeke....
sometime dr will do their work in the unthinkable way that we hv evr think..
hehehe..

This post has been edited by carloompunk: Sep 5 2007, 04:04 AM

From the anus, u could palpate the prostate..

Is it hard or soft?
Is it big?
Is it moveable?
How is the membrane feel??


In gynacology case, for virgin, Vagina examination is not encouraged to be done, instead, it will be an anus check. As Vagina examination will rupture the hymen...
However, for some case, vagina examination is mandatory. In that case, The doctor will menyampaikan u 1 certificate -"congratulation, ur hymen is rupture because of a medical action" Please remember, virgin is female that never hv sexual intercouse before, not depend on whether their hymen is intact or not.


Anyway, some onchologist categorize cervical cancer as sexual transmited disease, As HPV (human papiloma virus) has been found in 99& of the cervical cancer patient.. And how does HPV transmitted? BY sexual intercourse!! So, If u are still virgin, basically u are safe.

And if both u and ur bf/husband do not have other partner, then u are safe. There is no way the virus can be transmitted..

So, Here come the problem... Why can women get cervical cancer? Who is doing the wrong things?

So, guys, please always love ur gf or wife.. Sometimes what have u done may make them suffer.

Other things, CIN (cervical intraepithelial Neoplasm) aka the pre cervical cancer, is very very very currable. However, if u ignore the problem, in 8-10yrs, CIN will eventually become deadly cervical cancer.. And Pap smear is actually invented to screen CIN rather than cervical cancer..

This post has been edited by ivzh: Sep 19 2007, 11:00 PM

so scary la..
i got few bf b4, but current one last for about 2 years
b4 him last about 3 yrs...in btw got 1yr no bf..so...like this i should check right?

when shall we start to test this??
i mean between what age??

Female should start to do Pap smear test since they are sexually active (20-70). The interval of the test is at most 3 years once.. (better if 2 years once)

And based on the evidence base study, it can prevent 90% of cervical cancer!!

I think female should really really think about it very seriosly..

btw, how much does the test cost

If you look at current evidence, the recommendation is to start pap smear screening at the age of 25 (if you're sexually active). The reason is that screening has not been shown to reduce the rate of cancer in women below 25. Furthermore, the number of abnormal smears not due to cancer will be high (mainly due to transient HPV infection) and this will lead to unnecessary worry and procedures....

Also, as long as your pap smear is normal, the recommendation is for a 3-yearly smear and not more frequent than that.

Depends on where you do it. It can be as cheap as RM10-20 in family planning clinics and more expensive at GP....

This post has been edited by kmarc: Nov 6 2007, 06:25 PM

This topic remind me that i have pass my due date 4 d recent papsmear test

free in government clinics.

will only cost u ur time if u go at d wrong time, hehe.

The test should be started when you are sexually active.

There is a vaccine available now against the human pappiloma virus that causes cervical cancer. It is highly recommended that you take this vaccine.

Yup. There are 2 vaccines in the market now - "Gardasil" and "Cervarix". They are relatively very new products. Studies up to now indicates that the vaccines are very effective in preventing cervical cancer in the future. Recommended for women up to age 26 years old although there are on-going studies to see whether older or infected women would benefit from it.

i think if really want to check,go for specialist - gynae.

"pap smear is showing inflammatory changes. otherwise normal."

what does it mean guys?

huhuhu.....i m scared to go for papsmear too. kena kangkang infron og doctor,shy...

yeah anybody can recommend a good place? and pricing too... whoa very shy

Good place where? Penang?

Uhh. I was thinking of PJ Area actually.

Thought want to go Sunway Medical Center, what's your opinion?

The last time I did it was 2 years ago at Pantai Medical Centre.

It hurts.

A small amount of bleeding may occur after the test. <<<----OMG~ nearly faint when i c these! ...

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Added on March 4, 2008, 5:01 pmpainful??

This post has been edited by blax3: Mar 4 2008, 05:01 PM

For those who have never had their pap smear before, it doesn't hurt that much, you'll feel the discomfort, but if you try to relax, it helps.

It's normal to have spotting (small amount of blood) after the smear, so nothing to worry about.

The public clinics provide this test - I know this because my mom's working in one and she's performing smear tests for people.

It costs RM30 at Twin Towers Medical Centre for the pap smear test..

gals .. pls go for pap smear if ur

-sexually active b4 the age of 21
-recommended 3 years after sexual exposure
-for girls who changes their partners frequently
-ONE night stand ? forget about this sentence - never ever go for it !! high risk group
-age > 30,married - 1 year once until u obtain a consecutive 3 negative results - then proceed with once in 2 years


ps-the HPV virus will manifest in you around the age of 20+ and u will manifest with the disease only at the age of 30 or 40+,its a very slow growing virus and depends on the virus trand itself..

so screening is important !!

Sorry to say but your information is not in accordance with national guidelines.

For Malaysia, the recommendation is sexually active women between the age of 20-65 years old should be screened. If the first 2 consecutive pap smear (yearly) are normal, a 3 yearly screen is recommended, provided all the smears are normal.

For UK, women are invited to start screening at age 25. 3-yearly screen until age 50, then 5-yearly screen until age 65....

It is not because of a slow growing HPV that leads to cervical cancer, it is because of persistence of infection with high-risk HPV viruses. Most HPV infections are transient (about 4/5 of infected women clear their infection without developing any abnormal smear....)

erm... i've heard the guidelines u mentioned above.does it apply to non-sexually active women as well?

Any places [clinic] recommended for Setapak area.. Not going for GH though its near.

It doesn't apply to those who has never had sexual intercourse before i.e. a virgin.

It does, however, apply to those currently not active sexually but had experienced sexual intercourse before, irregardless of the duration of the last sexual intercourse.....

This post has been edited by kmarc: Apr 12 2008, 10:34 PM

hi, i'd like to go for pap smear test, any recommendation of clinic/doctor?

thanks

Hi all,
Kudos to every1 who contributed to this thread..informative indeed

Would like to ask the floor for recommendation for female body check / health screening, any recommendable female gynae in KL or Selangor area? Wanted to bring my gf to check, she's shy and nervous coz 1st time checking, so any kind soul please help me out. Tq.

---

Added on June 6, 2008, 12:14 amNo one kind enuf to help me out here?

This post has been edited by D80: Jun 6 2008, 12:14 AM

i did mine for less than RM100 and the doc is a lady doctor. her clinic is now near kampung kerinchi.

regardless your age and sexual history, it's good to have precautions. i read an article on this woman who's 24 and the doctor told her she's too young to have a pap smear and now she has cervical cancer.

take care of ourselves, gals!!

hmm she's not comfortable with a male gynae?
depending on your budget also..
i did my pap-smear test once at pantai cheras under dr.ho choon moy..
she's okay.. very quick..and the nurses are friendly

Oh, pantai cheras hospital..
May i know how much to anticipate?
Thanks alot..

it depends actually..
government hospitals are definitely cheaper in ways but not so sure about the handling process anyway..
it cost about RM150.. you should ask the price first.. it's good to go for body check ups from top to toe at least once a year...
oh and blood test too..

Yar, no gov hospital for this kinda things for me.. i actualli wanted to do the whole body check-up, datz why abit concern about the cost

Any ideas?

Hmm I think whole body check-up with blood test and pap smear is about RM600 plus, if I'm not mistaken..
You could call Dr. Ho @ 03-91320800 and inquire..

This post has been edited by elena_k: Jun 12 2008, 11:08 AM

Thanks alot for ur advise, will do consult with my gurl.

If anyone wants to do a pap smear test - remember to ask whether is a thin prep. Read here for more info http://www.thinprep.com/cervical-screening/thinprep.html

If u r refering Woman's health Screening - there are 2 types that a woman should look into. One is below 40 & one is above 40 yrs old. All woman above 40 yrs old should go for mamogram (to detect breast cancer).But if you have family history of breast cancer like mom, aunties, sisters etc, then you may do mamogram at the age of above 30+.

If any female is sexually active one must not hide from your gynae and don't be shy and afraid to tell your medical history. Best time to do your pap smear is 2 weeks after your menstrual.If you find that you are comfortable with female gynae go for female and if you don't mind any gender then it's ok

If do pap smear only is cheap but if you wanna do whole female check up with the specialist, the cost is higher. Most of private hospitals will have female health Screening and good gynae.

You may call up the private hospitals to find out who are their gynae or email them and ask them for a list of gynae list.Ask for their credentials or visit the hospitals website to get the doc's list. You can even ask them the woman health screening package price to be emailed to you. And do a comparison.

Cheers!

dont worry...

Ca cerviks occure when...

sexually active-changing partner
many children
u married with guy who his previous wife died due to cervical ca
multiple partner...

coz this disease it coz by HPV virus which is sexual transmitted disease...

if u r virgin, dis wouldnt be a problem...

so no need for you to do the pap smear.... n it is not rekomended though...

n it is better if you do the pap smear yearly...


sorry, my english is not good...

i have been went to injection of cervical cancer prevention before doing this test... so recommend that i go to this test too??